Gastroesophageal Reflux disease - Essay Example

Gastro-oesophageal reflux disease affiliation A Gastro-oesophageal reflux disease (GERD) is a term that refers to the digestive problem that is associated with defects of the lower oesophageal sphincter. This condition results into a reflux of the gastric contents back to oesophagus, which provokes clinical signs and symptoms that impair life. Symptoms of the disease include regurgitation and heartburn; other symptoms may be pain during swallowing, stomach pain and choking sensation.The Pathophysiology of GERD is multifactorial since it incorporates relaxation of the lower oesophageal sphincter as well as abnormalities of pressures related to the lower oesophageal sphincter.

Other factors that are involved in pathogenesis of GERD included the reflux of gastric acid and pancreatic enzyme that lead to injury of the oesophageal mucosa. In essence, the defence mechanism of the oesophagus are in two ways i.e. clearance and resistance of the oesophageal mucosa. Oesophageal clearance plays a significant role in neutralising the acid that is refluxed through the LES. Enhanced clearance reduces the time that oesophagus is exposed to the corroding effect of gastric acid mixtures.

The mucosal resistance of the oesophagus offers a protective mechanism and if these defences fail then oesophagitis ensues as a complication of GERD. The Lower oesophageal sphincter (LES) has a significant role in causing GERD. Dysfunction of LES may occur due to transient relaxation of LES and increase of intra-abdominal pressure that exceed the pressure of LES. Delay in gastric emptying may cause GERD because of the increased pressure in the stomach that may overcome the pressure of LES. A Hiatal hernia may cause GERD because it may push LES to move proximally into the chest making it lose its high-pressure area in the abdomen (Kahrilas, 2010).

Management of GERD involves lifestyle modification as well as the use of medication to reduce gastric acid. The lifestyle modifications include weight loss, elevating head of bed if experiencing nocturnal symptoms and avoidance of food that worsen the symptoms. Proton pump inhibitors, for example, Omeprazole, Lansoprazole and rabeprazole are the drug of choice in managing GERD. These drugs inhibit the secretion of gastric acid from the gastric parietal cells. H2-receptor antagonists are used in mild cases, which act by competitively blocking histamine receptors specifically those of gastric parietal cells.

These drugs include ranitidine, cimetidine and nizatidine among others, they are also used as maintenance therapy to prevent relapse of oesophagitis (Patrick, 2011).ReferenceKahrilas, P. J. (2010). GERD pathogenesis, pathophysiology, and clinical manifestations. Cleveland Clinic Journal of Medicine. Patrick, L. (2011). Gastroesophageal reflux disease (GERD): A review of conventional and alternative treatments. Alternative Medicine Review.